Look up the most recent NPI and PECOS records

Therapy Based Psychiatry Pc

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

30101 Agoura Ct Ste 204, Agoura Hills, CA 91301-4341

PECOS Enrollment

Based on the most recent information from CMS, provider Therapy Based Psychiatry Pc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1477323954
Provider Type
Organization
Full Name
Therapy Based Psychiatry Pc

Subpart
No
Enumeration Date
1/4/2024
Last Updated
1/4/2024

Contact Information

Practice Location

30101 Agoura Ct Ste 204, Agoura Hills, CA 91301-4341

(805) 889-0709

(562) 261-1098

Mailing Location

30101 Agoura Ct Ste 204, Agoura Hills, CA 91301-4341

(805) 889-0709

(562) 261-1098

Authorized Official

Najafian Jazi, Ali (Ceo)

(805) 889-0709

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 2084P0805X	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License Unlisted Issuer

Therapy Based Psychiatry Pc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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Brownfield, Faye Evelyn

Pillai, D.V.

Mohammad, Akikur Reza

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Mac, Daljit

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